Provider Demographics
NPI:1932667847
Name:KAPA, CHARLOTTE AMUNOH
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:AMUNOH
Last Name:KAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17803 LA CANTERA TER APT 11303
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2556
Mailing Address - Country:US
Mailing Address - Phone:773-750-2313
Mailing Address - Fax:
Practice Address - Street 1:17803 LA CANTERA TER APT 11303
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2556
Practice Address - Country:US
Practice Address - Phone:773-750-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-10
Last Update Date:2019-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health